Second line extracorporeal photopheresis for cortico-resistant acute and chronic GVHD after allogeneic hematopoietic cell transplantation for hematological malignancies: Long-term results from a real-life study.
Transfus Apher Sci
; 63(3): 103899, 2024 Jun.
Article
de En
| MEDLINE
| ID: mdl-38402067
ABSTRACT
BACKGROUND & OBJECTIVES:
The primary objective of this observational study was to perform an exhaustive description concerning patients receiving extracorporeal photopheresis (ECP) as second line treatment after steroid resistance for either acute or chronic GVHD following allo-HCT, secondary objectives were to evaluate the efficacy and long-term outcomes. STUDYDESIGN:
A total of 106 patients were included, 65 (61%) males and 41 (39%) females with a median age at transplantation of 52 years (range 20-67). ECP was initiated after transplantation either for acute GVHD [N = 25 (24%), 12 grade III and 13 grade IV] affecting skin alone (N = 5), gut alone (N = 12), gut and liver (N = 8), or chronic GVHD [N = 81 (76%), 15 (14%) limited and 66 (62%) extensive].RESULTS:
Among the 25 patients treated for acute GHVD, 67% were responders and among the 81 patients with chronic GVHD, 78% were responders. Patients with acute GVHD had a median OS of 6 months with a survival probability at 2 years of 35% [95%CI 14-56]. Patients with chronic GVHD had a median OS of 72 months with a survival probability at 2 years of 68% [95%CI 56-78]. There was a significant difference in terms of survival for patients responding to ECP compared to non-responders in both acute and chronic GVHD forms. Acute GVHD grade III-IV, negatively impacted on OS (HR=7.77, 95%CI 1.7-34), p = 0.007 and on disease relapse HR= 5.88, 95%CI 1.7-20, p = 0.005.CONCLUSION:
We demonstrated that ECP is an effective treatment for GVHD in a good proportion of patients with high overall response rate.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Photophérèse
/
Transplantation de cellules souches hématopoïétiques
/
Tumeurs hématologiques
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Maladie du greffon contre l'hôte
Limites:
Adult
/
Aged
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Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Transfus Apher Sci
Sujet du journal:
HEMATOLOGIA
Année:
2024
Type de document:
Article
Pays de publication:
Royaume-Uni